1.Left Ventricle Longitudinal Strain Parameters Are Effective for Differentiating Cardiac Amyloidosis from Primary Hypertensive Left Ventricular Hypertrophy
Ri-qing FENG ; Yuan-li MENG ; Ying-mei LIU ; Qiong QIU ; Shao-xin ZHENG ; Bing-qing DENG ; Yu-lin WEI
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(6):1046-1052
ObjectiveTo clarify the value of the left ventricular longitudinal strain(LVLS)parameters in patients with cardiac amyloidosis (CA) and primary hypertension with left ventricular hypertrophy (HLVH). MethodsForty-one patients confirmed with CA were selected and assigned to CA with hypertension group (n =14) and pure CA group (n=27) based on the initial diagnosis with or without hypertension. Twenty patients with primary hypertension-induced left ventricular hypertrophy (HLVH group) and twenty healthy controls were also selected, matching for gender, age, and body surface area. Clinical data, conventional echocardiography parameters were collected and LVLS parameters were measured. Within-group variations were compared among the four groups, and pairwise comparisons were conducted between groups. The sensitivity and specificity of each parameter in predicting CA were judged by the receiver operator characteristic (ROC) curvy in CA and HLVH patients with left ventricular ejection fraction (LVEF) preserved. ResultsAmong the conventional echocardiography parameters, LVEF and left ventricular end-diastolic diameter (LVEDD) were lower in the CA with hypertension group and pure CA group compared with the higher values in the HLVH group and control group. Whereas, left ventricular posterior wall thickness (LVPWT), relative wall thickness (RWT), and average E/e' were higher in the two CA groups compared with the HLVH group (all P<0.05).Among the LVLS parameters, Global longitudinal strain (GLS) was the worst in the CA with hypertension group so as pure CA group, modest in the HLVH group, and highest in the control group. On the contrary, relative longitudinal strain and ejection fraction strain ratio (EFSR) were the highest in the CA with hypertension group so as to pure CA group, modest in the HLVH group, and lowest in the control group (all P<0.05). ROC analysis showed that when LVEF was preserved, the absolute value of GLS less than 14.35% and EFSR higher than 4.28 could effectively distinguish CA from HLVH (all AUCs>0.9,all P<0.05); meanwhile GLS showed high sensitivity(100%) and EFSR showed great specificity(95%). There were not statistically significance in any parameter between CA with hypertension group and pure CA group(all P>0.05). ConclusionWhether CA was complicated with hypertension or not, there were statistically significance among routine echocardiography and LVLS parameters compared with HLVH. In particular, GLS and EFSR are accurate in predicting CA in patients with myocardial hypertrophy and preserved LVEF.
2.Risk Factors for in-Hospital Mortality in Patients with Takotsubo Syndrome
Yuan-li MENG ; Ri-qing FENG ; Pei-wei WANG ; Xi CHEN ; Wei WU ; Yu-lin WEI
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(1):122-130
ObjectiveTo analyze the risk factors for in-hospital mortality in patients with Takotsubo Syndrome (TTS). MethodsHospitalization data of consecutive patients with TTS from February 2009 to January 2022 were retrospectively collected and analyzed. Patients were divided into survival group and death group according to outcomes. The basic clinical information, triggering factors, laboratory examinations, electrocardiogram, echocardiography, complications and treatments of the two groups were compared. Univariable logistic regression analysis was used to screen the possible risk factors for in-hospital mortality in TTS patients, and multivariable logistic regression analysis was used to determine the independent risk factors for in-hospital mortality in TTS patients. ResultsA total of 62 TTS patients were included in our study, including 21 males (33.9%), 41 females (66.1%) and 26 postmenopausal women (41.9%), with the mean age of (55.6±16.2) years, and physical triggers were found in 50 patients (80.6%). 17 patients (27.4%) died while 45 patients (72.6%) survived during hospitalization. The death group had lower systolic blood pressure and left ventricular ejection fraction (LVEF), higher incidence rate of syncope, higher level of N-terminal pro-B natriuretic peptide (NT-proBNP) and hypersensitive troponin T (hs TnT) when compared with survival group (all P value <0.05). As for the triggering factors, the proportion of TTS induced by neurologic disorders in the death group was higher than that in the survival group (P<0.05). The death group had higher rates of cardiogenic shock, malignant ventricular arrhythmia, atrial fibrillation, and respiratory failure (all P value <0.05). Compared with the survival group, therapeutic dopamine, therapeutic norepinephrine, hemodialysis and mechanical ventilation were higher in the death group (all P value <0.05). Univariable logistic regression analysis suggested that syncope, NT-proBNP, LVEF, neurologic disorders, cardiogenic shock, malignant ventricular arrhythmia, atrial fibrillation, respiratory failure, therapeutic dopamine, therapeutic norepinephrine, hemodialysis and mechanical ventilation were potential risk factors for in-hospital mortality in TTS patients (all P value <0.05). Multivariable logistic regression analysis indicated that neurologic disorders [OR(95%CI)=5.651(1.195,26.715),P=0.029], atrial fibrillation [OR(95%CI)=6.217(1.276,30.298), P=0.024)] and therapeutic norepinephrin [OR(95%CI)=8.847(1.912,40.949), P=0.005] were independent risk factors for in-hospital mortality in TTS patients. ConclusionsNeurologic disorders, atrial fibrillation and therapeutic norepinephrin are independent risk factors for in-hospital mortality in patients with Takotsubo Syndrome. Clinically, attention should be paid to the prevention and treatment of neurologic disorders and atrial fibrillation; norepinephrine should be carefully used in patients with diagnosed TTS complicated with hemodynamic instability.
3.Study on time-toxicity relationship and mechanism of Gardeniae Fructus extract on hepatoxicity in rats based on proteomics.
Feng ZHOU ; Kai ZHANG ; Zhi-Wei CAI ; Yin-Fang CHEN ; Xiao-Bo ZENG ; Xi-Zhe HE ; Xiao-Die HU ; Qing WEN ; Ri-Yue YU ; Li-Ping HUANG
China Journal of Chinese Materia Medica 2021;46(1):162-170
To study the time-toxicity relationship and mechanism of Gardeniae Fructus extract on the hepatoxicity in rats. Rats were randomly divided into C group(0 day), D5 group(5 days), D12 group(12 days), D19 group(19 days), and D26 group(7 days recovery after 19 days of administration). The rats in normal group received normal saline through intragastric administration, and the rats in other groups received 10 g·kg~(-1 )Gardeniae Fructus extract through intragastric administration. After the final administration, the livers were collected. Hematoxylin-eosin staining was used to observe the histopathological changes in the liver tissue. Total liver proteins were extracted for proteomic analysis, detected by the Nano-ESI liquid-mass spectrometry system and identified by Protein Disco-very software. SIEVE software was used for relative quantitative and qualitative analysis of proteins. The protein-protein interaction network was constructed based on STRING. Cytoscape software was used for cluster analysis of differential proteins. Kyoto encyclopedia of genes and genomes(KEGG) database was used to perform enrichment signal pathway analysis. Pearson correlation analysis was performed for the screened differential protein expression and liver pathology degree score. The results showed that the severity of liver injury in D5, D12 and D19 groups was significantly higher than that in group C. The degree of liver damage in D5 group was slightly higher than that in D12 and D19 groups, with no significant difference between group D26 and group C. Totally 147 key differential proteins have been screened out by proteomics and mainly formed 6 clusters, involving in drug metabolism pathways, retinol metabolism pathways, proteasomes, amino acid biosynthesis pathways, and glycolysis/gluconeogenesis pathways. The results of Pearson correlation analysis indicated that differential protein expressions had a certain temporal relationship with the change of liver pathological degree. The above results indicated that the severity of liver damage caused by Gardeniae Fructus extract did not increase with time and would recover after drug with drawal. The above pathways may be related to the mechanism of liver injury induced by Gardeniae Fructus extract.
Animals
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Drugs, Chinese Herbal/toxicity*
;
Fruit
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Gardenia
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Liver
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Proteomics
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Rats
;
Signal Transduction
4.Risk factors for metabolic bone disease of prematurity in very/extremely low birth weight infants: a multicenter investigation in China.
Xiao-Ri HE ; Can LIANG ; Yuan-Qiang YU ; Pei-Jia WU ; Xiang-Hong CHEN ; Yu-Jun CHEN ; Cui-Qing LIU ; Xiang-Dong OU-YANG ; Ruo-Bing SHAN ; Wei-Wei PAN ; Yan-Mei CHANG ; Dan WANG ; Xiao-Yun ZHONG ; Kai-Ju LUO ; Yong-Hui YANG ; Qing-Yi DONG ; Jin-Tao HU ; Ming-Feng HE ; Xiao-Mei TONG ; Ping-Yang CHEN
Chinese Journal of Contemporary Pediatrics 2021;23(6):555-562
OBJECTIVE:
To investigate the incidence rate and risk factors for metabolic bone disease of prematurity (MBDP) in very low birth weight/extremely low birth weight (VLBW/ELBW) infants.
METHODS:
The medical data of 61 786 neonates from multiple centers of China between September 1, 2013 and August 31, 2016 were retrospectively investigated, including 504 VLBW/ELBW preterm infants who met the inclusion criteria. Among the 504 infants, 108 infants diagnosed with MBDP were enrolled as the MBDP group and the remaining 396 infants were enrolled as the non-MBDP group. The two groups were compared in terms of general information of mothers and preterm infants, major diseases during hospitalization, nutritional support strategies, and other treatment conditions. The multivariate logistic regression analysis was used to investigate the risk factors for MBDP.
RESULTS:
The incidence rate of MBDP was 19.4% (88/452) in VLBW preterm infants and 38.5% (20/52) in ELBW preterm infants. The incidence rate of MBDP was 21.7% in preterm infants with a gestational age of < 32 weeks and 45.5% in those with a gestational age of < 28 weeks. The univariate analysis showed that compared with the non-MBDP group, the MBDP group had significantly lower gestational age and birth weight, a significantly longer length of hospital stay, and a significantly higher incidence rate of extrauterine growth retardation (
CONCLUSIONS
A lower gestational age, hypocalcemia, extrauterine growth retardation at discharge, and neonatal sepsis may be associated an increased risk of MBDP in VLBW/ELBW preterm infants. It is necessary to strengthen perinatal healthcare, avoid premature delivery, improve the awareness of the prevention and treatment of MBDP among neonatal pediatricians, and adopt positive and reasonable nutrition strategies and comprehensive management measures for preterm infants.
Birth Weight
;
Bone Diseases, Metabolic/etiology*
;
China/epidemiology*
;
Female
;
Humans
;
Infant
;
Infant, Extremely Low Birth Weight
;
Infant, Newborn
;
Infant, Premature
;
Infant, Very Low Birth Weight
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Pregnancy
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Retrospective Studies
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Risk Factors
5.Environmental heavy metals and cardiovascular diseases: Status and future direction
Ai-Min YANG ; Kenneth LO ; Tong-Zhang ZHENG ; Jing-Li YANG ; Ya-Na BAI ; Ying-Qing FENG ; Ning CHENG ; Si-Min LIU
Chronic Diseases and Translational Medicine 2020;06(4):251-259
Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and obser- vational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.
6.Environmental heavy metals and cardiovascular diseases: Status and future direction
Ai-Min YANG ; Kenneth LO ; Tong-Zhang ZHENG ; Jing-Li YANG ; Ya-Na BAI ; Ying-Qing FENG ; Ning CHENG ; Si-Min LIU
Chronic Diseases and Translational Medicine 2020;06(4):251-259
Cardiovascular disease (CVD) and environmental degradation are leading global health problems of our time. Recent studies have linked exposure to heavy metals to the risks of CVD and diabetes, particularly in populations from low- and middle-income countries, where concomitant rapid development occurs. In this review, we 1) assessed the totality, quantity, and consistency of the available epidemiological studies, linking heavy metal exposures to the risk of CVD (including stroke and coronary heart disease); 2) discussed the potential biological mechanisms underlying some tantalizing observations in humans; and 3) identified gaps in our knowledge base that must be investigated in future work. An accumulating body of evidence from both experimental and obser- vational studies implicates exposure to heavy metals, in a dose-response manner, in the increased risk of CVD. The limitations of most existing studies include insufficient statistical power, lack of comprehensive assessment of exposure, and cross-sectional design. Given the widespread exposure to heavy metals, an urgent need has emerged to investigate these putative associations of environmental exposures, either independently or jointly, with incident CVD outcomes prospectively in well-characterized cohorts of diverse populations, and to determine potential strategies to prevent and control the impacts of heavy metal exposure on the cardiometabolic health outcomes of individuals and populations.
7.Lymphocyte-variant hypereosinophilia: one case report.
Jun Qing XU ; Ri Ming LIU ; Xiang Yan FENG ; Kai Min LI ; Yan WANG ; Li WANG ; Yuan Feng ZHANG ; Xiao Qian LIU ; Jun Jie MA ; Xiao Xia CHU
Chinese Journal of Hematology 2018;39(7):592-592
8.A study on the growth effects of SD rats by repeated restraint in dermal exposure test
Ya-Li HUANG ; Guan-Long LI ; Wei-Qi LAI ; Wei CHEN ; Juan XU ; Yong ZHU ; Qiong-Jiang CHEN ; Ri-Ping CHEN ; Jia-Li ZHANG ; Ya-Qing HONG ; Fang-Fang ZHANG ; Feng JIN ; Liu-Jin GU
Journal of Preventive Medicine 2017;29(10):983-986,990
Objective To analysis the effects on the growth of rats by repeated restraint in dermal exposure test. Methods SD rats in the restraint group was bound for 6 hours per day for 91 days according the way by dermal exposure, while SD rats in the control group didn't receive the treatment. Clinical signs, body weight and food consumption changes were observed for 91 days. When the study was terminated, hematology, clinical biochemistry, urinalyses, gross necropsy, and histopathology were carried out. Statistical methods such as the generalized estimating equation were used to compare the differences between two groups. Results The statistical results of generalized estimating equation showed that there was an interaction between the group and test time for male and female rats in body weight changes (P<0.05), and the body weight of male rats in the restraint group was lower than the control group (P<0.05) . Further analysis showed that for male rats there was significant difference between groups since the forth week (P<0.05), and the interaction was found between groups and test time (P<0.05) . For female rats, the interaction was found since the eighth week between the group and test time (P <0.05) .There was no significant differences in other parameters between two groups (P>0.05) . Conclusion Repeated restraint during dermal exposure affected the body weight gain of rats, and the sensitivity of male rats was higher than that of female rats.
9.Two new xanthones from Lomatogonium carinthiacum.
BA-GEN-NA ; Yu-Lan CHEN ; BADERIHU ; Yu-Feng TONG ; YE-RI-GUI ; Qing-Hu WANG
Chinese Journal of Natural Medicines (English Ed.) 2014;12(9):693-696
AIM:
To study the chemical constituents of Lomatogonium carinthiacum (Wulfen) Rchb.
METHOD:
The CHCl3-soluble fraction was separated by chromatography and the structures of the new compounds were elucidated by spectral experiments.
RESULTS:
Two new xanthones, 1, 8-dihydroxy-4, 5-dimethoxy-6, 7-methylenedioxyxanthone (1), 1, 4, 8-trimethoxyxanthone-6-O-β-D-glucoronyl-(1→6)O-β-D-glucoside (2) were isolated from the whole plant of Lomatogonium carinthiacum.
CONCLUSION
Compounds 1 and 2 are new natural products.
Gentianaceae
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chemistry
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Glucosides
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chemistry
;
isolation & purification
;
Molecular Structure
;
Plant Extracts
;
chemistry
;
Xanthones
;
chemistry
;
isolation & purification
10.Preparation, in vitro evaluation of excipient-free dry powder inhalation of extraction of Trollius chinensis.
Ting FAN ; Yun-Feng ZHU ; Qing-Ri CAO ; Jing-Hao CUI
China Journal of Chinese Materia Medica 2013;38(13):2096-2100
To prepare and evaluate dry powder inhalation (DPI) of extraction of Trollius chinensis Bunge (TCB). Orthodox design was employed to optimize the parameters of spray drying to prepare micronized TCB powder, the DPI was prepared by mixing micronized TCB powder and lactose. The results showed that the fine particle fraction (FPF) and emitted dose (ED) of micronized TCB powder was (21.07 +/- 1.74)%, (75.31 +/- 21.05)%, respectively, and for DPI was (56.4 +/- 2.2)%, (95.9 +/- 3.0)%, respectively. Therefore, the prepared DPI meeted requirements in the Chinese Pharmacopeia, indicating a good application prospect.
Administration, Inhalation
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Dry Powder Inhalers
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Excipients
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Plant Extracts
;
administration & dosage
;
isolation & purification
;
Powders
;
Ranunculaceae

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